Proceedings of the 4th International Conference on Educational Innovation and Philosophical Inquiries

DOI: 10.54254/2753-7048/13/20230895

Effects of Childhood Trauma on Adolescent Mental Health

Xiaolin Xiao1,a,†, Yuxi Zhao1,b,*,†, and Sitong Zhou2,c,†
1
Department of German, Binhai School of Foreign Affairs of Tianjin Foreign Studies University, 60
Xuefu Road, Yingbin Street, Binhai New Area, Tianjin, China
2
Institute of Education, Hainan Normal University, No.3 Xiaoji First Road, Guilinyang, Meilan
District, Haikou, Hainan, China
3
Faculty of Teacher Education, Nanjing Audit University Jinshen College, 100 Xianlin Avenue,
Xianlin Street, Qixia District, Nanjing, China
a. x2849790278@163.com, b. YZHAO98@depaul.edu, c. zhou2210566629@163.com
*corresponding author
†
These authors contributed equally.

Abstract: Adolescent mental health issues are being increasingly acknowledged, yet the bulk
of adolescent psychological issues may be traced back to childhood. This literature review
provides a comprehensive analysis of the association between childhood trauma and mental
health disorders in adolescents. A systematic search of relevant terms including emotional
abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, non-suicidal self-
injury, suicide, aggressive behavior, Internet addiction, post-traumatic stress disorder,
depression, and cognition was conducted. This review meticulously catalogs and discusses
psychological disorders based on their specific classifications, resulting harms, association
with childhood trauma, mediating mechanisms, and coping techniques. The findings from
numerous pertinent journals and literature highlight a significant correlation between
childhood abuse and neglect and various aspects of adolescent behavior, mood, and cognition.
By a variety of intermediary systems, this association may be indirectly related. Treatment
enables intervention and prevention of adolescent mental health issues. Several articles have
demonstrated that childhood trauma has negative consequences on adolescent mental health.
Unfortunately, there are research in this sector, and the majority of them is cross-sectional or
has restrictions. Therefore, the contribution of this paper is to inspire readers or future
researchers to further explore the effects of childhood trauma on adolescent psychology.

Keywords: childhood abuse, childhood neglect, adolescent psychological problems

1. Introduction
Currently, mental health is a topic of concern, and the issue of adolescent mental health has been
regularly brought up. The recent death of 15-year-old Hu Xinyu, who hanged himself due to
psychological problems, has catapulted adolescent mental health to an unprecedented level of social
awareness. Adolescence is the period of transition from childhood to adulthood, which is also a
crucial time. Its qualities include sensitivity and susceptibility to external environmental variables;
this is the period during which psychological illness is most easily detected. 10% to 20% of
adolescents globally suffer from mental health issues, according to a study [1].
© 2023 The Authors. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0
(https://creativecommons.org/licenses/by/4.0/).

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The majority of teenage mental health difficulties may be traced back to childhood. Academics in
the United States have begun to focus on the harmful effects of childhood trauma on youth mental
health over the past few years. For example, Chuanyong Liu and collaborators assessed the impact of
childhood trauma and intuitive stress on depression as well as an anxiety disorder in teens and found
that these adolescents had more childhood trauma experiences [2]. There is an association between
adolescent mental illness and childhood psychological trauma, as supported by both domestic and
international research [3].

2. The Types and Specific Definitions of Childhood Trauma

The Childhood Trauma Questionnaire (CTQ-SF) demonstrated by Bernstein et al. outlines five
subcategories of childhood trauma: emotional abuse, physical abuse, sexual abuse, emotional neglect,
and physical neglect [4].
Moreover, based on the number of traumatic episodes youngsters go through, some experts
classify childhood trauma as Type I Disorder (single traumatic event) or Type II Disorder (repeated
or persistent traumatic events). Emotional abuse and physical neglect are type II disorders, along with
parental divorce and separation, which can cause long-lasting trauma in children [5].
Addressing the precise definition of childhood trauma, Jongsma argued that persons who have
undergone the following circumstances may be considered to have had psychological trauma during
childhood: 1) have had adverse emotional, physical, or sexual experiences in childhood; 2) emotional
or physical neglect caused by lack of parental care and companionship during childhood; 3) parents
with mental illness, antisocial behavior, or substance abuse; 4) parents who move frequently, are
under great financial pressure, change their parenting frequently, or engage in promiscuous behavior;
and 5) parents who are perfectionists, demanding, constantly belittling or criticizing others, adhering
to a perfectionist parenting style [6]. Since the childhood trauma questionnaire is one of the most
often used instruments to explore the impact of childhood trauma events, it is utilized as a reference
for this review.

3. The Harm of Childhood Trauma to Adolescents’ Mental Health

3.1. Behavior
3.1.1. Non-suicidal Self-injury (NSSI) and Suicidal Behavior
Non-suicidal self-injury (NSSI) is the improper, supervise, and repetitive mutilation of the liver
absent suicide ideation by means of burns, cuts, scalds, and skin-scratching [3]. Since NSSI is more
prevalent among adolescents around the world, it has received considerable attention from researchers.
Both domestic and international studies reveal that childhood trauma is linked to NSSI in teenagers.
A sample survey of an arbitrary German population with an age bracket of 48.4 years, as well as a
ratio of 53.3% females vs males, revealed that participants with a heritage of self-injury expressed
higher incidences of childhood abuse across all categories of abuse (emotional abuse, physical and
sexual abuse, psychological and physical neglect). Mental abuse and neglect were demonstrated to
be directly related to self-injury, whereas the impacts of physical and sexual abuse were completely
buffered by self-expression and psychological coping [7]. Recent research on Chinese adolescents
has found a link between childhood emotional abuse and self-injury [8]. Wenzhi He and colleagues
conducted the study. Nanning middle school students provided samples that confirmed these findings.
According to the study’s findings, different types of childhood trauma have varying degrees of
influence on the NSSI of middle school students. The most significant overall impact on NSSI is
sexual abuse, followed by emotional and physical abuse [9]. Due to the young average age of the
samples in this domestic study and the cultural peculiarity of one-child households, the research

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findings differ slightly from those of the German study cited previously. Even if the majority of this
research are cross-sectional or retrospective, the probability of recall bias is enough to explain the
connection between both non-suicidal self-injury in adolescents and childhood trauma. This is true
even if the majority of these studies are retrospective.
Stewart et al. define suicidal behavior as the intentional self-destructive behavior of killing oneself
[10]. In recent years, the rate of youth suicide has increased, although research on the impact of
traumatic events on suicidal behavior in China is still limited. Most suicidal teenagers with a history
of childhood trauma, as noted in the relevant literature [11], are adolescents with a history of
depression. Early international research has established a high correlation between childhood
maltreatment and neglect and suicide. Abuse in childhood, particularly sexual abuse, increases the
likelihood of suicide conduct [12].

3.1.2. Aggressive Behavior

Aggression is one of the most prevalent sorts of teenage behavior issues. Typically, it refers to
physical or verbal activity that is intended to cause harm to others. This kind of behavior can be
harmful to both the individual and the community. In terms of the relationship involving childhood
trauma and adolescent aggressiveness, Lewis et al. reviewed crime files and unearthed that 80 to 90
percent of offenders had suffered abuse and a quarter of those who experienced severe abuse as a
child were convicted of a crime [13]. An association between the prevalence of early abuse and an
increase in aggressiveness ratings was validated by a second study with non-clinical adolescents in
Germany. The study’s findings indicate that childhood abuse is, in fact, a risk factor for later violent
conduct [14]. Social learning theory explains this phenomenon by proposing that children who
experience violence may internalize these acts as typical and adopt them in their future interactions
with others. According to Dodge et al., a variety of dysfunctions, including emotional control and
comprehension, caused by childhood trauma may contribute to adolescent aggressiveness. Although
the aforementioned research varied in their analyses of the origins of aggression, they all point to the
conclusion that early abuse has a direct effect on aggressive behavior.

3.1.3. Internet Addiction (IA)

Due to the Internet’s surge in popularity and extensive use, the issue of “Internet addiction” has
evolved and is highly prevalent among adolescents. Regarding the definition of Internet addiction
(IA), no clear standard exists. According to the “Clinical Diagnostic Criteria for Internet Addiction”,
it is a mental and behavioral illness induced by excessive and recurrent Internet use [15].
Several factors influence IA. Individuals’ self-control, according to the “limited self-control
theory,” is limited and easily undermined. Nonetheless, childhood abuse causes stress, which reduces
self-control [16]. Relevant foreign studies have confirmed this conclusion: a sample study involving
children and adolescents of various ages and family backgrounds from across the country shows that
child abuse promotes the development of poor self-control and that there is a significant negative
correlation between the two [17]. Thus, childhood abuse will impair the self-control of adolescents
and result in Internet addiction. In addition, Geng Xu and colleagues sampled middle school pupils
from the province of Anhui. They discovered that emotional, sexual, and physical abuse in childhood
were risk factors for mild IA in adolescents [18]. This suggests further that childhood trauma has a
deleterious effect on IA in young individuals.

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3.2. Emotion
3.2.1. Depression
In this paper, depression is primarily defined as a mental illness characterized by severe and persistent
bad mood and abnormalities in emotional control [19]. An increasing number of articles on adolescent
depression in recent history have demonstrated that depression has significantly hampered adolescent
development. Individual emotions, thinking, self-feeling, interpersonal communication, study, and
work are all negatively impacted. According to research, many depressed teenagers experienced
childhood psychological trauma such as loss, abuse, or separation [20]. Relative to their counterparts,
adolescents who experienced early psychological trauma are far more vulnerable to suffering from
psychological illnesses like depression [21]. Using 176 adolescents (12-17 years old) and freshly
onset adults (18-29 years old) with unipolar depression as research samples, Rocque et al. discovered
that patients with emotional maltreatment in childhood were more sensitive to stress [22]. In this
context, the study by Ling et al. revealed that emotional neglect, as well as abuse, were the most
significant predictors underlying depressive symptoms in adolescents who had psychological trauma
as children [23]. In addition, Wenhong Cheng et al. discovered that the rate of childhood trauma in
adolescents with depression was significantly greater than in teenagers of the same age who were not
depressed. The rate of depression among those with a history of early trauma was 3.79 times that of
those without such a history. Furthermore, the degree of depression was found to be considerably
higher among those who had a past of early trauma in comparison to people who did not have this
experience [20].

3.2.2. Post-traumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD) refers to the psychological symptoms that an individual might
develop after experiencing a traumatic incident [24]. Burt et al. noted that children are prone to PTSD
following exposure to a traumatic experience, with rates ranging from 3 to 100 percent. Researchers
investigated if there was a link between the number of traumatic experiences children and adolescents
had and the prevalence of PTSD. 15–43% of women and 14–43% of males have reported having gone
through at least one traumatic experience in their lifetimes. Moreover, 90% of children who were
sexually abused, 77% of children who were victims of school shootings, and 35% of urban children
who were victims of communal violence had PTSD symptoms.
It has additionally been proven that family support and parental coping techniques can influence
PTSD symptoms. Studies have demonstrated that PTSD symptoms are less severe in children and
adolescents with greater family support and less parental distress [25]. Adolescents who experienced
childhood psychological trauma are more prone to develop PTSD, yet increased family support can
also be beneficial for sufferers.

3.3. Cognition
Typically, behaviors interacting with the external environment influence cognitive function
development. Cognitive abilities include learning, researching, comprehending, summarizing, and
analyzing. Childhood trauma can have a negative impact on cognition, particularly memory, which
is important because it affects a person’s future growth. Early traumatic experiences have been linked
to mental damage in adolescents, according to studies. After a childhood trauma, the structure,
function, and neural development of brain areas will change, with the hippocampus being the most
affected. Individuals who have undergone psychological trauma in childhood will have diminished
hippocampal volume and reduced memory performance. In addition, the academic performance of
adolescents may decrease as a result. If adolescents are dissatisfied with their educational experiences,

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they will eventually lose confidence and deteriorate psychologically and cognitively. In a word,
childhood trauma has a direct effect on adolescents’ cognitive development. On the other hand, it is
possible to lessen the negative effects of trauma by receiving timely and specific treatment for
cognitive difficulties [26].

4. Meditating Variable Modulating the Effects of Children’s Trauma on Adolescent

Mental Health
Childhood trauma affects teenage mental health both directly and indirectly via a range of mediating
factors, particularly when it comes to emotional and behavioral issues. According to a study by Huisi
Ding, Psychological Resilience may serve as a mediator between the two variables. Some researchers
believe that psychological resilience is the ability of teenagers to seek assistance from family, society,
and other factors in times of difficulty. People with great mental resilience can utilize their conditions
to overcome trauma and other obstacles and have fewer emotional and behavioral issues [27].
According to studies, childhood trauma influences depressive symptoms both directly and indirectly
through psychological resilience [27].
Social support and coping styles, in addition to psychological resilience, are critical components.
Jialu Hou et al. discovered that psychological trauma in childhood can have an indirect effect on
adolescent depression via social support. Individuals who are supportive are more likely to overcome
childhood trauma. Depression is more likely to develop in the absence of family and societal support
following childhood trauma. A study found that the mediating effect of psychological style accounted
for 17.24%, showing that psychological style has a substantial influence on the likelihood of
depression among adolescents who have encountered traumatic events. Additional relevant research
has examined the combined impact of peer support and responding styles, termed the chain influence
effect, and found that social support and coping styles contribute 8.05 percent to adolescent
depression [28] (see Figure 1). In conclusion, both support networks and coping mechanisms play a
substantial role in mediating the considerable connection between early psychological stress and
adolescent depression.

Figure 1: Model of chain mediating effects [28].

Furthermore, discovered to be a mediator between traumatic childhood experiences and mental

health is rumination. Nolen-Hoeksema characterizes rumination as a form of responding to distress
in which individuals passively and persistently ponder about unpleasant events, their causes, and
dismal outcomes, but do not take positive measures to better the situation or actively escape it [29].
Psychological abuse, sexual abuse, and overprotection of children by their parents during childhood
contribute to this mentality. Children’s inability to correctly manage their emotions and control their
environment, resulting in the formation of negative cognition and ruminating thoughts, which can
lead to depression and other psychological problems, is a consequence of the lack of attention paid to
their emotional problems and emotional expression by those around them.

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Self-esteem is also a mediator of child maltreatment and adolescent psychological issues.

According to Jiping Yang’s research on childhood abuse and adolescent cyberbullying, abused
children will watch and mimic abusive behaviors due to low self-esteem and aggression perception,
and will act violently toward their peers [30]. According to the attachment theory of self-esteem,
those with insecure-avoidant attachment styles are more aggressive. When adolescents lose control
of their emotions, they frequently engage in harmful behavior, so perpetuating a vicious cycle of
violence. The primary reason for this is that their poor self-esteem is exacerbated by the unfavorable
comments they receive for their aggressive behavior as children. And self-esteem plays a crucial
influence in children’s interactions with the outside world. Teenagers with poor self-esteem will
engage in a sequence of violent actions to compensate for their low self-esteem and other
psychological issues. In contrast, those who grow up in a pleasant and harmonious family
environment have higher self-esteem and are less likely to experience emotional issues in adolescence
[30].

5. The Remedy and Prevention of Adverse Psychological Effects on Adolescent

5.1. Remedy
In accordance with the findings of a comprehensive analysis of previously conducted research, one
of the factors that inhibit the development of adolescents is mental health problems. Immediate care
is essential for adolescents who have experienced emotional trauma during their childhood and who
have preexisting mental health conditions.

5.1.1. Portrait Therapy

Early psychological trauma has the potential to have a negative effect on a patient’s self-worth, yet
portrait therapy can help patients reshape their sense of self to a certain extent. This intervention’s
major objective is to achieve self-identity repair by exposing patients to self-portraits conceived and
drawn by art therapists. Throughout treatment, the therapist will construct and analyze the patient’s
life experience using collages, sculptures, and portraits to create a safe therapeutic environment. This
approach will cause patients to relax their guard, assist them in establishing a stronger sense of
identity in their hearts, actualize memory and integration desensitization, and ultimately have a
therapeutic effect [31].

5.1.2. Behavior Modification Techniques

Childhood psychological stress increases the likelihood that adolescents may participate in aggressive,
violent, or criminal behavior. They are associated with issues like as inferiority, irritation, and crowd
avoidance, which are treatable through behavior modification and intervention. It is feasible to
establish self-control in people with irritability and aggressive conduct by moderate catharsis [32].
Yet people with inferiority complexes, social anxiety, and other issues can frequently be motivated
to reach the goal of boosting self-confidence. The reinforcement should continue appropriately after
the patient’s symptoms have improved to consolidate the outcomes.

5.1.3. Improvement of Family Environment

A harmonious and happy family can provide patients with the spiritual and material nutrition they
need for rehabilitation, as well as raise individuals with high self-esteem who are less vulnerable to
setbacks. The impact of the family environment on patients is significant. With a variety of activities,
parents can try to nurture patients’ trust, maximize their sense of safety, and mitigate the detrimental
impacts of psychological issues.

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5.2. Prevention
Early prevention is the most effective method to lessen the negative effects of childhood trauma.
According to Bronfenbrenner’s Ecosystem Theory, the human development environment is an
ecosystem comprised of microsystems, mesosystems, and ecosystems, and the macrosystems are
interconnected. The microsystems of children consist of their environment, family, kindergarten,
school, and natural environment [33]. Once irregularities are detected, parents and teachers in such
an atmosphere should take immediate action to protect children from psychological damage by
maintaining constant vigilance.
Mesosystems relate to the links between multiple “micro” ecosystems in which humans interact
and are directly immersed. For example, the relationships between houses (home and school) and
between instructors and parents. The importance of home-school cooperation is central to this
approach. Instructors should swiftly inform parents about their children’s kindergarten or school
status. In addition, parents should provide their children with great companionship and interaction,
as well as scientifically based care. So that they may feel a sense of support and closeness.
Ecosystems include contexts such as networks, groups, and neighborhoods, in which a child may
or may not be active but may be influenced. The age of information explosion, in which all types of
information are combined, has arrived. Children’s cognitive development is limited, as is their ability
to distinguish between right and wrong. As a result, parents must assist their children in screening
information and limiting their children’s exposure to negative external influences. Furthermore, the
community, campus, and family should collaborate to promote children’s healthy development and
reduce the prevalence of psychological stress.

6. Conclusion
This review classifies and discusses the negative effects of childhood trauma on adolescent
psychology. Combined with relevant research results at home and abroad, it concludes that there is a
correlation between childhood trauma and young people’s psychological problems, and different
types and degrees of childhood trauma will cause different degrees of negative effects on adolescents
and adults. In addition, this paper proposes some coping strategies for the above-mentioned trauma
types and trauma consequences, mainly some remedial and preventive measures. Although this view
is supported by relevant research results, few studies have been conducted on the effects of childhood
trauma on adolescent mental distress, and most of these studies are cross-sectional or influenced to
some extent by unavoidable objective factors. More researchers will be needed to fill this gap in the
future, as the subject is still relatively underdeveloped. Therefore, this paper will contribute to
inspiring not only future researchers to pay more attention to this field, but also parents to care more
about the negative effects of childhood trauma on adolescent psychology. Besides, teachers play an
essential role in assisting students who suffer from the negative effects of childhood trauma on
adolescent psychology. If there is any policy about protecting these students, a better world would be
created.

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